Patient Education · Endocrinology
Interventional Endocrinology
Image-guided, minimally invasive procedures for endocrine disease — thyroid nodule ablation (RFA & ethanol), liver elastography, and Eversense CGM insertion.
We are proud to be the first center in San Diego to offer ultrasound-guided RFA and ethanol ablation for thyroid nodules. To find out if you are a candidate, please contact our office or call (858) 622-7200.
Presenting at ENDO 2026 · The Endocrine Society Annual Meeting
Our thyroid RFA experience was accepted for presentation at ENDO 2026 in Chicago — the Endocrine Society’s annual meeting and the largest gathering of endocrinologists in the world. Our work, “Single-session trans-isthmic radiofrequency ablation for benign thyroid nodules: a 24-month single-practice experience,” reviews 118 consecutive patients treated in our office and adds to the growing U.S. evidence for a technique that lets many patients avoid thyroid surgery.
Interventional Endocrinology
What is Interventional Endocrinology?
Interventional endocrinology is an emerging field that uses percutaneous (through-the-skin), image-guided procedures to treat endocrine diseases — using far less invasive techniques than traditional surgery. The most commonly performed procedures include ultrasound-guided ethanol ablation and ultrasound-guided radiofrequency ablation (RFA) of specific types of benign thyroid nodules, as well as treatment of lymph nodes with recurrent thyroid cancer.
What are thyroid nodules and who is at risk?
A thyroid nodule is a growth of thyroid tissue or a fluid-filled cyst that forms within the thyroid gland. They are extremely common — approximately 75% of all people will develop a thyroid nodule during their lifetime, most without knowing it. Problems arise when nodules grow large enough to interfere with breathing or swallowing, cause excess hormone production, or create cosmetic concerns.
Traditionally, thyroid surgery or radioactive iodine were the only treatment options for problematic nodules. Non-surgical ablation techniques have changed that.
Radiofrequency Ablation (RFA)
What is Thyroid Radiofrequency Ablation (RFA)?
Thyroid RFA uses a small needle that delivers precisely controlled radiofrequency energy to heat and destroy nodule tissue. The same technology is used to treat tumors in the liver, lung, kidney, breast, and bone, and has been used for thyroid tissue worldwide since 2002.
RFA is performed in-office under local anesthesia. Patients are awake and able to breathe and speak throughout the procedure. After numbing the neck, Dr. Schneider inserts a small needle under continuous ultrasound guidance and moves it through the nodule using the “moving shot” technique until the entire nodule has been ablated. The procedure takes approximately 15 to 30 minutes depending on nodule size. Patients can resume normal activities the same day.
Full RFA outcomes, candidacy, and cost
Our detailed thyroid RFA results — including outcomes from our own 118-patient series presented at ENDO 2026 — procedure detail, and cost are covered in depth on our dedicated interventional thyroid site. Visit sandiendo.com for the full picture →
What are the advantages and risks of RFA?
RFA is a very gentle, minimally invasive procedure. There is no incision, no neck scar, and no general anesthesia. Recovery time is very short. Unlike surgery, RFA spares healthy thyroid tissue — most patients do not require lifelong thyroid hormone replacement after the procedure.
Ethanol Ablation
What is Ultrasound-Guided Ethanol Ablation?
Ethanol ablation uses high-resolution ultrasound to guide the injection of a small amount of ethanol (alcohol) directly into a thyroid nodule or lymph node. The ethanol causes a controlled inflammatory response that selectively destroys the nodule tissue.
This procedure is particularly effective for cystic (fluid-filled) thyroid nodules, which are almost never cancerous (<1% for simple cysts) and carry a very low risk of malignancy (<3%) even when partially cystic. Ethanol ablation is considered when compressive symptoms are present or when the cyst is large — especially for patients in whom needle aspiration has failed (aspiration alone has a 60–90% recurrence rate). Patients with cystic thyroid nodules should not undergo neck surgery before considering non-surgical approaches.
Liver Elastography
What is liver elastography, and why does it matter?
Fatty liver disease (MASLD) is now one of the most common conditions in endocrinology. The key question is not simply whether fat is present in the liver, but whether the liver has begun to scar — a process called fibrosis. Liver elastography answers that question without a biopsy. Using Siemens Sequoia ultrasound with Virtual Touch Tissue Quantification (VTTQ) shear-wave elastography, we measure the stiffness of the liver in the office to estimate the degree of fibrosis and follow it over time. This helps identify patients who need closer attention and confirms improvement as metabolic treatment takes effect — all without a needle.
Part of how we manage fatty liver disease
Liver elastography is one tool in our approach to MASLD. See MASLD & Fatty Liver Disease →
Eversense CGM Insertion
What is the Eversense implantable CGM?
Continuous glucose monitoring has transformed diabetes care. The Eversense system takes it further with a long-term sensor placed just under the skin of the upper arm, lasting far longer than adhesive sensors before it needs to be replaced. Inserting and removing the Eversense sensor is a brief, in-office procedure performed under local anesthesia. Offering it directly — rather than referring it out — reflects how our practice adopts advanced diabetes technology for our patients.
Advanced diabetes technology
Eversense is one of several technologies we use in diabetes care. See Diabetes →
Am I a Candidate?
Who performs these procedures and how is expertise ensured?
These procedures require unique, specialized training to be performed safely and with good results. Dr. Schneider has unparalleled expertise in clinical thyroidology and ultrasonography, and was trained in ultrasound-guided interventional techniques by Dr. Korkusuz in Frankfurt, Germany — a pioneer in the field. His combined expertise in clinical thyroidology, interventional endocrinology, and ultrasonography is unique in San Diego.
A multidisciplinary discussion among specialists is critical to determining candidacy. We work closely with head and neck surgeons, nuclear medicine physicians, and radiologists when evaluating patients for these procedures.
How do I find out if I’m a good candidate?
If you are interested in RFA or ethanol ablation and would like to discuss whether you would be a good candidate, please contact us to schedule a consultation.
Explore our dedicated thyroid RFA center
San Diego Thyroid RFA is our focused center for non-surgical thyroid nodule treatment — with detailed procedure information, candidacy guidance, and consultation scheduling in one place.
